Topic: The Diabetes Prevention Program.
David Katz: One example of the kinds of programs and the power that we have coming
from the research community is the diabetes prevention program. The diabetes prevention program took 3,500 or so adults with pre-diabetes, so we’re really on diabetes’ doorstep, and randomly assigned them to one of three treatments: usual care, drug treatment with a drug called Metformin or Glucophage, and the lifestyle intervention arm. And this study was funded by the NIDDK which is one of the institutes at the National Institutes of Health, or NIH, to the tune of 174 million dollars; big study, important study. It was stopped early after 4 years because the results were so dramatic.
3,500 adults who were going to get diabetes soon. The drug worked very well. It actually prevented diabetes in 30% of those high risk adults; so almost one in three, who would’ve gotten diabetes without that treatment didn’t. Pretty good. The lifestyle intervention however, prevented diabetes in 58%. It was twice as good. Now what was this? Was this some very creative diet? Only eat rutabaga under the light of the full moon while standing on one foot?
Balanced, sensible nutrition: eat food, not too much, mostly plants, a healthy diet ala Michael Pollan, modern physical activity on a daily basis, modest weight loss – translated into a 58% reduction in the occurrence of diabetes. A clear indication of the power of lifestyle over health. The challenge now and many people are working on this, is the development of the community-based programs that will translate what we learned in the diabetes prevention program and put it to work in every town in America. How do we make this play in Peoria? Or New Haven, Connecticut where I come from? Or any other town?
So in our case, we took that program which clearly is the best practice, there’s an educational program attached to the DPP. We said if we can find an inexpensive way to make this infiltrate the community, maybe we can see some of those gains in diabetes prevention where we live.
So we developed a program called “PREDICT – Partners Reducing the Effects of Diabetes Initiatives through Collaboration and Teamwork.” This was funded by the centers for disease control. We worked with African-American churches in New Haven and Bridgeport, Connecticut, to identify leaders in the congregation in the community who would become pure educators. So we trained them in diabetes prevention. We taught them the lifestyle arm of the diabetes prevention program and then we said “Pay it forward. You know your community. People listen to you. People respect you. If you care about this and you’re knowledgeable, you can reach people that we probably can’t.” Coming from academia, they distrust us. You really need to be part of community.
Recorded on: July 06, 2009